Integration Of NICUs Into Hospitals
NICUs are currently one of the most discussed topics in the world of evidence-based design. As part of the Spencer de Mille Traveling Fellowship through the International Interior Design Association (IIDA) Northern Pacific Chapter Knowledge Advancement Fund, I have the opportunity to participate in this exciting field of study.
Early next year, I will travel to Abu Dhabi, UAE, to tour the Danat al Emarat Women’s & Children’s Hospital and then to Stockholm, Sweden, to visit the Karolinska Institutet and its hospital. My goal is to research and benchmark the integration of NICUs into hospitals by looking at five aspects: patient room layout and adjacencies, flow and efficiency of the space, use of salutogenic design principles, community integration, and technology.
I will use observation and interviews to summarize how NICU design research is impacting us practically and hopefully get a glimpse of what’s in store for the future.
Intending to nab a holistic pulse on the current NICU sphere, my first step was to attend the Healthcare Design Conference in November where I focused on NICU-related and children’s focused sessions.
My favorite statement of the conference was overheard at the Patient-Centered Design Reception where someone proposed the question, “Should we treat them [premature babies in NICUs] as newborns who we welcome to our world with all the sensory stimulation that comes with it or perhaps should we treat them as fetuses that happen to be out here just by chance?”
I believe this question will become increasingly prominent as we move forward with NICU research. The answer isn’t necessarily one or the other but rather discovered by looking deeper into child development from inside the womb until after birth. NICU design needs to become adaptable to where babies are in their development process. For example, premature babies may need lower lighting levels, more intimate spaces, or more moisture in the air.
In my travels, I hope to gather information on aspects such as these and how they may affect premature newborns if altered. These aspects could become part of our salutogenic design approach.
Several of the conference sessions I attended left me with the impression that the NICU environment—like healthcare in general—is in a transition period where research will need to shift its focus to the healing environment as a community.
The NICU is becoming more a part of the hospital and the hospital is becoming more a part of the community. NICUs will no longer be a function separated from everything else. They will be integrated with children’s hospitals, women’s clinics, general family practice, psychiatry, and other parts of the healthcare system, creating a better balance to care.
In planning, we need to discover more about how NICUs and the rest of healthcare are related and how spaces can take the shape of a family or community unit while still offering privacy. By doing this we can improve the efficiency and effectiveness of our care.
On a smaller scale, product design, technology, and NICUs should work together to develop more innovative solutions. At the Patient Centered Design reception, students showed a rotating trash receptacle they designed that’s built into the wall.
Replacing trash can liners causes a lot of noise and clutter and can be disruptive to patients in a NICU room. This product eliminates that problem because the full trash can be rotated and emptied outside of the patient room. Some of the nurses were so ecstatic about how this could change the way they work that they told the students that they should patent their design.
On a larger scale, research should further address the relationship of NICUs to the hospital and the community. This affects NICU design because as much as we create design standards, we need to look at every design as a unique reflection of the specific location where the NICU facility resides.
Not only does hospital culture vary among facilities, but world cultures vary in their approaches to healthcare, child rearing, privacy, and the list goes on. In NICU design the development of best practices and standards is essential, but understanding patient and culture variation and targeting our designs accordingly will greatly improve the quality of our healthcare.
For photos and more updates on my travels, visit http://iida-northernpacific.org/knowledge-fund/.
Gloria Cornell is an interior designer at B+H Architects (Seattle).